Toba Bryant and I are doing a story-telling session about SDOH in Atlanta
next week. The checklist half-way through lists any number of potential
allies in raising the issues of SDOH and may be of value...
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Building A Broad National Coalition to Address the Social Determinants Of
Health In Canada
Dennis Raphael and Toba Bryant, York University, Toronto, Canada
[log in to unmask] http://www.atkinson.yorku.ca/draphael
[log in to unmask] http://quartz.atkinson.yorku.ca/tbryant
Story-Telling Session at the International Conference:
Overcoming Health Disparities: Global Experiences from Partnerships between
Communities, Health Services and Health Professional Schools, October 6-10,
2004, Atlanta, Georgia, USA
Goals and Specific Learning Objectives of the Session
Goal: To describe how a national coalition of academic, social justice,
social welfare and development, early childhood, labour and other activists
came together to raise the profile of the social determinants of health in
Canada.
Objectives:
1. Identify the groundwork necessary for such efforts;
2. Describe the importance of trust and solidarity in bringing together
diverse sectors;
3. Identify supports such as government funding of research and conference
efforts, existence of progressive social, labour, and political networks,
and push for health care reform in Canada;
4. Identify barriers to such efforts such as medical and lifestyle
approaches to health; and
5. Describe how the effort is being supported by
a. The Toronto Charter on the Social Determinants of Health
b. Health Canada and other organizations
c. The Social Determinants of Health Listserv at York University
d. Publication of Social Determinants of Health: Canadian Perspectives
e. The media
f. The Wellesley Central Health Corporation in Toronto
6. Outline future courses of action to support the SDOH agenda.
Agenda
Introductions
Outline of recent policy and research developments in Canada and elsewhere
Telling our story
Soliciting experiences from others
Identifying barriers and supports to our efforts
Building collaborations within and without national borders
Introductions
Who you are, where you are from, and how have you come to be interested in
the SDOH?
Background to the Canadian Scene
1) Adoption of neo-liberal economic agenda by Federal Liberals (1993)
2) Election of neo-conservative government in Ontario (1995)
3) Publication of Wilkinson's Unhealthy Societies: The Afflictions of
Inequality (1996)
4) Erosion of Canadian leadership role in health promotion and population
health
5) Retreat to lifestyle health promotion emphasis among public health units
across Canada
6) Increasing scholarship in health inequalities
a) Ongoing UK work - U Bristol, UC London, others
b) US Scholarship - U Michigan, Harvard, National Policy Institute, U Cal,
others
a) Canadian Population Health Initiative
b) Statistics Canada and Health Canada research and publications
c) WHO-EURO Social Determinants of Health: Solid Facts/Healthy Cities
d) Ongoing NGO work - Campaign 2000, Canadian Council on Social
Development, National Council of Welfare, United Ways, Canadian Centre for
Policy Alternatives, and others.
Social Determinants of Health: A Current Accounting and Policy Implications
1. Call for Proposals by Health Canada Policy Research Program
2. Determining list of health determinants for consideration
a. Evidence
b. Understandable to the public
c. Area of current concern or obvious neglect
d. Aligned with governmental policy-making structures
3. Determinants identified
a. Aboriginal status
b. early life
c. education
d. employment and working conditions
e. food security
f. health care services
g. housing
h. income and its distribution
i. social safety net
j. social exclusion
k. unemployment and employment security
4. Rationale and Structure of Conference
a. Authority would present on current state of the determinant
b. Authority would present on health implications of the state of the
determinant
c. Poster presentations
d. Proceedings and volume planned
5. Identifying Speakers
a. Personally known to organizers or identified through networks
b. Gender and geographically balanced
c. Policy and policy change oriented
d. Role of trust and solidarity
e. Expectations of an activist approach
f. Extensive advertising, outreach and planning
Outcomes
1. Toronto Charter for a Health Canada
2. SDOH Listserv at York University
3. Posting of proceedings by Health Canada
4. Informal network of interested parties from a variety of diverse sectors
5. Social Determinants of Health: Canadian Perspectives by Canadian
Scholars Press
6. Adoption by Wellesley Central Health Corporation of a social
determinants approach
Local Experiences
1. What is the local situation in your jurisdiction?
2. What are some of the supports in your jurisdiction?
3. What are some of the barriers? Political, institutional, professional,
and psychological, etc.?
A Checklist for Supports and Barriers
What is your association with each of the following? Is it positive,
negative, or non-existent? What could be done to facilitate positive
contact?
1. anti-poverty groups
2. disease associations
3. early childhood and care/daycare advocates
4. education structures and school system
5. ethnic/cultural groups
6. faith groups
7. federal/national government/civil servants
8. food banks/food distribution systems
9. funding agencies
10. Health Canada (or equivalent) regional offices
11. housing and homelessness groups
12. labour unions
13. local hospitals/health centres
14. local political representatives
15. local public health units
16. local social service agencies
17. media
18. municipal councils/civil servants
19. political parties
a. governing parties
b. opposition parties
20. public policy institutes
21. professional associations
a. dentistry
b. medicine
c. nursing
d. psychology
e. public health
f. social work
g. others
22. provincial/state governments/civil servants
23. social justice groups
24. social planning/social development councils
25. United Ways/other charitable NGOs
26. universities/colleges
Identifying Potential for Collaborations Within and Without National
Borders
How can we support each other in raising and addressing the social
determinants of health?
What resources are now available? What are needed? What can we do to
support this agenda?
Canadian Resources
Income, Inequality, and Wellbeing
Caledon Institute of Public Policy -- http://www.caledoninst.org/
Canada's Voice for Progressive, Practicable Social Policy provides reports,
analyses and updates on latest issues.
Campaign 2000 and the Child Poverty Working Groups --
http://www.campaign2000.ca
Their website is an excellent source of child-centred information on
federal and provincial budgets, political debates and demographic reports.
Canadian Centre for Policy Alternatives --
http://www.policyalternatives.ca
The Centre monitors developments and promotes research on economic and
social issues facing Canada. It provides alternatives to the views of
business research institutes and many government agencies.
Canadian Council on Social Development (CCSD) -- http://www.ccsd.ca
The CCSD is a social policy and research organization focusing on social
welfare and development issues of poverty, social inclusion, disability,
cultural diversity, child well-being, employment, and housing.
Canadian Policy Research Networks (CPRN) -- http://www.cprn.com
The CPRN's mission is to create knowledge and lead public debate on social
and economic issues important to the well-being of Canadians.
Centre for Social Justice (CSJ) -- http://www.socialjustice.org
The CSJ's work is focused on narrowing the gap between rich and poor,
challenging corporate domination of Canadian politics, and pressing for
policy changes that promote economic and social justice.
Institute for Research on Public Policy (IRPP) - http://www.irpp.org
The IRPP seeks to improve public policy by generating research, providing
insight and sparking policy debate.
National Council on Welfare (NCW) -- http://www.ncwcnbes.net
The NCW advises the Canadian government on matters related to social
welfare and the needs of low-income Canadians. NCW publishes several
reports each year on poverty and social policy issues.
Work-Place and Health Related Websites
http://www.iwh.on.ca is the web site of the Institute for Work and Health,
the leading Canadian research and advocacy organization on issues relating
to work and health.
http://www.clc-ctc.ca is the web site of the Canadian Labour Congress, the
national umbrella organization for 2.5 million unionized Canadian workers.
The Social and Economic Policy sub site contains many research papers on
labour market issues. The site links to the web sites of many unions, in
Canada and around the world.
http://www.jobquality.ca is a sub site of the web site of the Canadian
Policy Research Networks and contains a wealth of current data on the
quality of jobs in Canada.
http://www.eurofound.ie is the web site of the European Foundation for the
Improvement of Living and Working Conditions. Data are available from
three European Surveys on Working Conditions, 2000, plus many studies of
changing workplace conditions.
http://www.ilo.org is the web site of the International Labour
Organization, a United Nations organization that promotes 'decent work.'
The site contains research studies on labour and on working conditions
around the world.
Early Childhood Education and Care Websites
Childcare Resource and Research Unit, University of Toronto --
http://www.childcarecanada.org
Childcare Advocacy Association of Canada --
http://www.childcareadvocacy.ca/
These provide latest research and policy developments in early childhood
education and care from around the world.
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